The first time migraine hits can be a frightening experience. There is a whole army of migraineurs out there, with new sufferers being diagnosed every day. For all of them there was that dreadful, first time experience.

Maybe you’ve had headaches all your life but suddenly get one that knocks you off your feet, or maybe the pain suddenly sprang from nowhere with no apparent warning. You could also have felt other unfamiliar symptoms such as bright, jagged or pulsing lights in your eyes, feeling sick for no reason, or having tingling sensations and numbness in your limbs. You could even feel confused, have trouble organizing your thoughts or expressing them.

The additional symptoms are aura manifestations many migraineurs experience. For some, they are a welcome warning sign because medication taken at this stage can sometimes ward off pain before it starts. Prompt action is needed, however, so it’s vital new sufferers learn about their migraine patterns as soon as possible.

Defining Migraine Headaches

There are strict criteria by which migraine is diagnosed. It’s far from a normal bad headache and there are myriad causes and possible treatments.

The features of your headache can help you make a first guess yourself before visiting a doctor:

• How it feels — migraine pain is variously described as throbbing or pulsing and is often (but not always) on one side of the head. Patients have described it as feeling as though their head is in a vice. Others have said it feels like ice picks drilling their brain. Migraine can last up to 72 hours, or may resolve after an hour or so.
• Associated symptoms — you may develop unusual sensitivity to light or sound, feel lightheaded or dizzy, and have vision disturbances or numbness in one side of your body. You may feel sick, or actually vomit, and you may also feel confused or muddled.

Almost half the people with migraine go undiagnosed but by getting proper medical help, you have far more chance of effectively managing the condition.

Ongoing Management

One of your first steps should be to start a migraine diary or journal. Because there are so many different things that trigger an attack, keeping a detailed record of activities, food, surroundings and even the weather can reveal potential triggers you wouldn’t ordinarily notice.

An example might be drinking several glasses of red wine. If you can drink one glass and not get migraine, you may not associate wine as a trigger. It’s only when you discover three glasses give you migraine that you realize there’s a link between wine and pain.

Your sleeping pattern is another example, because hormonal fluctuations can trigger an attack. When we sleep, the body produces hormones such as cortisol and melatonin, so losing sleep or lying-in at the weekend could set up physical conditions leading to migraine.

You could either simply make written notes, or use a smartphone app if its more your style.

Migraine Medication and Treatments

While it’s scary, migraine is treatable with prescribed medications and those you buy over the counter, as well as other forms of treatment. Your doctor may prescribe or recommend:

Preventive medication, which is taken daily and might include:

• Anticonvulsant medications such as Topamax or Neurontin. It’s not fully known why these medications help prevent migraine, but they work for some people.
• Beta-blockers, commonly used to treat heart disease, which help prevent blood vessels contracting or dilating.
• Tricyclic antidepressants.
• Botox injections. These are now approved by the FDA for migraine treatment in some people.

Preventive medications are usually prescribed when you have four or more debilitating episodes per month, if pain lasts longer than 12 hours, or other pain relievers don’t work.

Abortive or acute medications are those which help stop headaches once they’ve started. These may include:

• Triptans, which can help with nausea or light and sound sensitivities as well as pain. They constrict blood vessels and can block pain pathways.
• Ergots, which contract blood vessels. They’re most effective when taken soon after pain starts, especially for those whose pain generally lasts more than 48 hours.
• Codeine, which is classed as a narcotic but is often prescribed for those with allergies or other side effects brought on by triptans or ergots.

Aspirin or ibuprofen helps some sufferers if taken as soon as aura starts, and can also help abort pain for some. But migraine is complex and there is no sure-fire treatment that works for everyone. Some find relief in alternative therapies such as massage, acupuncture, diet supplements or relaxation techniques. Most migraineurs find they need a combination of different treatments, along with adjustments in their lifestyle.

Research and study is ongoing, with new treatments emerging all the time. As soon as you suspect you’re having migraine headaches, see your doctor so you can start getting effective help.